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function and more stability because of greater surface area ofattachment to the adjacent teeth.A fixed passive appliance that doesn’t use bands and is eas-ily placed is called a splint.Here, an orthodontic wire is bentchairside and adapted to teeth adjacent to the prematurelylost tooth. The adjacent teeth are etched, sealant applied,and a resin bonding is placed on top of the ends of the ortho-dontic wire to hold the orthodontic wire in place. This isallowed to set up and is then finished and polished. It represents an easy and rapid method to achieve spacemaintenance.If teeth are missing on both sides of an arch in the mandible(lower jaw), a lingual arch can be used. This is also known asa lower lingual holding arch (LLHA).Here, bands are fit onboth six-year molars, and an impression is taken. An ortho-dontic wire is welded to the lingual aspect of the bands. It
runs along the lingual portion of the arch towards the lingualsurfaces of the mandibular incisors. Contact with the inci-sors is imperative, because it’s this contact that enables theappliance to hold the lower molars in their original positions.The lingual arch, band and loop, and band and bar hold portions of the arch space so that posterior teeth can’t moveforward and anterior teeth can’t move backward. This savesthe space left by the premature loss of the primary teeth. Inthe upper arch, a nance holding archcan be used, which isvery similar to a lingual holding arch with the exception thatinstead of contacting the lingual aspect of the incisors, asmall acrylic button is incorporated that touches the roof ofthe mouth, thus holding the molars in their position and notallowing them to drift backward.Fixed space maintainers are advantageous because they’rerelatively carefree and permanently cemented in the mouth,reducing the risk of loss. They’re generally well received bythe patient. A disadvantage might be that they’re somewhatdifficult to construct, involving welding, and if they comeloose it’s imperative to have them recemented as soon aspossible to maintain the fit of the appliance.An acrylic partial dentureis a removable type of space main-tainer, usually without bands. It can be active or passive. It’s commonly used with prematurely missing anterior teeth.Not only does it hold space for the eventual eruption of thepermanent tooth, but it also provides a more pleasingappearance. This often gives the patient more motivation to wear the appliance constantly and not lose it.The possible loss of a removable space maintainer is one ofits disadvantages. Another is that it may break when not inthe mouth. It also requires care and cleaning; the patientmust remove it and brush it thoroughly on a regular basis.